Validation of axillary sentinel lymph node detection in the staging of early lobular invasive breast carcinoma: a prospective study

BACKGROUND: Previous reports have shown that regional lymph node involvement in patients with early-stage breast carcinoma can be evaluated by resection of axillary sentinel lymph nodes (ASLN). Axillary lymphadenectomy may be unnecessary in the absence of ASLN involvement. In the current study, the authors compared the results of ASLN resection in patients with lobular invasive carcinoma (LIC) with the results from patients with ductal invasive carcinoma (DIC) in terms of detection rates and false-negative rates. METHODS: For ASLN detection, technetium 99m sulfur-colloid and patent blue were injected around the tumor. Each patient underwent both ASLN resection and complete axillary lymphadenectomy. Detection rates and false-negative rates were evaluated in patients with LIC and in patients with DIC. RESULTS: Two hundred forty-three patients with invasive, early-stage breast carcinoma were enrolled in the study (208 patients with DIC and 35 patients with LIC). The median patient age, pathologic tumor size, hormone receptor status, and rates of involved lymph nodes were equivalent for both groups. ASLN detection and false-negative rates did not differ for patients with LIC and patients with DIC. CONCLUSIONS: The ASLN detection rate was not dependent on the pathologic type of invasive carcinoma. Pathologic examination of ASLN in patients with LIC and in patients with DIC predicted axillary lymph node status with the same predictive value in terms of lymph node metastasis. For patients with LIC, ASLN examination overestimated the rate of micrometastasis as diagnosed by immunohistochemical techniques. These results will require confirmation in larger studies.     

Cortical and medial amygdala are both involved in the formation of olfactory offspring memory in sheep

Ewes form a selective olfactory memory for their lambs after 2 h of mother-young interaction following parturition. Once this recognition is established, ewes will subsequently reject any strange lamb approaching the udder (i.e. maternal selectivity). The present study tested the functional contribution of different amygdala nuclei to lamb olfactory memory formation. Using the anaesthetic lidocaine, cortical, medial or basolateral nuclei of the amygdala were transiently inactivated during lamb odour memory formation. Reversible inactivation of either cortical or medial amygdala during the first 8 h postpartum impaired lamb olfactory recognition, whereas inactivation of the basolateral nucleus or infusion of artificial cerebrospinal fluid did not. Control experiments indicate that inactivation of the cortical and medial nuclei of the amygdala specifically disrupt memory formation rather than olfactory perception or memory retrieval. These findings show that both nuclei of the amygdala are required for the formation of a lamb olfactory memory and suggest functional interaction between these two nuclei.     

Differential c-Fos expression in the newborn lamb nucleus tractus solitarius and area postrema following ingestion of colostrum or saline

Visceral stimuli and the gut-brain axis play a crucial role in the control of ingestion even in the neonate. The aim of this study was to assess the neuronal activation in the nucleus tractus solitarius (NTS) and the area postrema (AP) following nutritional and non-nutritional stimulations. Lambs received a single gastric infusion of colostrum or saline at 5% birth weight or were sham infused. Infusion of either liquid led to c-Fos-like immunoreactivity (c-FLI) in the NTS and AP. Differences were observed along the sections of the NTS rostro-caudal axis according to the nature of the stimulation, suggesting a specificity of certain afferents and/or NTS areas for nutritional or non-nutritional signals. In the AP, the neuronal activation induced by colostrum was much higher than that induced by saline. A higher number of TH-immunoreactive cells were activated following colostrum infusion, suggesting a specific involvement of the catecholaminergic pathway in the treatment of meal-related stimuli. In spite of functional convergence, the two medullary structures observed responded differently according to the stimulation, indicating a complementary role in the integration of visceral signals.     

Effective binocular integration at the midline requires the corpus callosum

To study the role of the corpus callosum (CC) in midline binocular integration, the effects of late callosotomy and congenital CC agenesis on the ability to perceive dichoptic plaid motion was assessed. Coherent motion was well perceived at all locations in the visual field under dioptic viewing but not along the vertical meridian (VM) when the components were dichoptically presented. This deficit was totally abolished in the agenesis subject and reduced in the callosotomized individual when stimulus size was increased beyond the VM. Electrophysiological correlates were also examined by recording visual evoked potentials and these showed that the P1/N2 components were abnormal for small dichoptic stimuli presented on the midline. These findings attest to the importance of the contribution of CC to midline binocular integration and the effects of cerebral plasticity.     

Decisional authority and moral responsibility of patients and clinicians in the context of preimplantation genetic diagnosis

Case reports reveal that clinicians applying preimplantation genetic diagnosis are increasingly confronted with requests by patients which they consider ethically problematic. These requests raise the question to what extent physicians share responsibility for the welfare of the future child. Two categories of situations are analysed: when patients unilaterally review the agreement made with the medical staff and when they request an application that increases rather than reduces the risk of having a termination of pregnancy. It is concluded that physicians have their own responsibility in the process, which allows them to introduce conditions before starting infertility treatment.     

Autism and the X chromosome: no linkage to microsatellite loci detected using the affected sibling pair method

The etiology of autism spectrum disorders (ASDs) is poorly understood, although it is clear that genetic factors play a major role. ASDs appear to be a heterogeneous group of disorders, making genetic analysis difficult in the absence of etiologically definable subgroups. The excess of males in the affected population has led to suggestions that an X-linked locus could play a role in the causation of autism or a related pervasive developmental disorder. To examine this, we have investigated the genotypes of 31 families with two or more affected boys, at a series of 16 highly polymorphic loci distributed along the X chromosome with an average interlocus distance of 12 cM, in order to identify regions of significantly increased concordance among pairs of affected brothers. No locus tested showed a significant increase in concordance, supporting findings by others that there are no genes of major effect located on the X chromosome that contribute to increased susceptibility to ASD.